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What is Retinal Detachment?

Retinal detachment is a separation of the retina, which is the light-sensitive layer in the back of the eye from its outer layers. The retina is a transparent membrane in the back of the eye. It helps you see the images that are focused on it by the cornea and the lens. Retinal detachments are often associated with a tear or hole in the retina through which eye fluids may leak into the sub-retinal space. This causes separation of the retina from the underlying layers.If not treated early, retinal detachment can cause permanent vision loss.

  • What are the different types of Retinal Detachment?

    There are three different types of retinal detachments:

    • Rhegmatogenous - A tear, hole or break in the retina allows fluid to leak under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of retinal detachments are the most common.
    • Tractional - In this type of detachment, blood vessels and scar tissue on the retinal surface contract and pulls the retina causing it to separate from the outer layers. This type of detachment is commonly seen in diabetics.
    • Exudative – It is caused by inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina.
  • What are the causes of Retinal Detachment?

    Retinal detachment often occurs on its own without an underlying cause. However, it may also be caused by trauma, diabetes, and inflammatory disorders. It is most often caused by a related condition called posterior vitreous detachment (PVD). During a retinal detachment, bleeding from small retinal blood vessels may fill the inside of the eye, which is normally filled with vitreous fluid. Central vision becomes severely affected if the macula, the part of the retina responsible for fine vision, becomes detached.

  • What is the risk for Retinal Detachment?

    A retinal detachment can occur at any age, but it is more common in people over age 40. A retinal detachment is also more likely to occur in people who:

    • Are highly myopic (extremely nearsighted)
    • Have had a retinal detachment in the other eye
    • Have a family history of retinal detachment
    • Have had a complication during cataract surgery
    • Have other eye diseases or disorders, such as retinoschisis, uveitis, degenerative myopia, or lattice degeneration
    • Have had an eye injury
    • Have uncontrolled diabetes
  • What are the symptoms of Retinal Detachment?

    Symptoms include a sudden or gradual increase in either the number of floaters, which are little "cobwebs" or specks that float about in your field of vision, and/or light flashes in the eye. Another symptom is the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

  • How is Retinal Detachment treated?

    Small holes and tears are treated with laser or cryopexy. These procedures are usually performed in the clinic as an outpatient procedure. With a laser, tiny scars are made around the hole to "weld" the retina back into place. Cryopexy freezes the area around the hole and helps reattach the retina. These procedures are done for early onset cases or those without detachment as a preventive measure.

    Retinal detachments are generally treated with surgery. In some cases a scleral buckle, a silicon band, is sutured to the eyeball from the outside to gently indent the wall of the eye against the detached retina. Avitrectomysurgery may also be performed in a large number of cases. Here, 3 tiny incision in the sclera (white of the eye) are made to gain access to the vitreous. Next, a small instrument called a cutter is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain its shape. Air and Gas is injected to into the eye to replace the vitreous and reattach the retina; the gas pushes the retina back against the wall of the eye. During the healing process, the eye secretes the fluid that gradually replaces the gas and fills the eye. With all of these procedures, either laser or cryopexy is used to stick the retina back in place. Silicon Oil is used in some cases with advanced problems like large or giant tears and proliferative retinopathy.

    With these latest procedures, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second surgery is needed. However, the final visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact a specialist immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.

  • What are the exams and tests carried out?

    Tests will be done to check the retina and pupil response and your ability to see colors properly. These may include:

    • Optical Coherence Tomography (OCT)
    • Fluorescein angiography
    • Intraocular pressure measurement
    • Indirect Ophthalmoscopy
    • Color vision test
    • Ultrasound of the eye
  • What are the possible complications that can occur?

    • Possible Complications

      The unsuccessful reattachment of the retina might be a result of formation of new/ fresh breaks in the retina, scarring or membrane formation, uncontrolled swelling of the retina and choroid, uncontrolled eye pressure and inflammation. These could be one of the reasons for recurrence and loss of vision.

    • Prognosis

      What happens will depend on the location and extent of the detachment, history of previous eye surgeries and early treatment. If the macula has not detached, the results of treatment can be excellent. Most retinal detachments can be repaired, but not all of them. The exact prognosis can be determined only after a thorough eye examination.

    • Prevention

      Use protective eye wear to prevent eye trauma. Control your blood sugar carefully if you have diabetes. See your eye care specialist at least yearly, especially if you have risk factors for retinal detachment like myopia or family history of retinal problems.